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La Revue Du Praticien Dec 2018
Topics: Delusions; Humans; Psychotic Disorders; Schizophrenia, Paranoid
PubMed: 30869239
DOI: No ID Found -
Current Pharmaceutical Design 2022Adherence to medication regimens is of great importance in psychiatry because drugs sometimes need to be taken for long durations in order to maintain health and... (Review)
Review
BACKGROUND
Adherence to medication regimens is of great importance in psychiatry because drugs sometimes need to be taken for long durations in order to maintain health and function.
OBJECTIVE
This study aimed to review influences on adherence to antipsychotic medications, the treatment of choice for the delusional disorder (DD), and to focus on adherence in women with DD.
METHODS
This is a non-systematic narrative review of papers published since 2000 using PubMed and Google Scholar, focusing on women with DD and medication adherence.
RESULTS
Several factors have been identified as exerting influence on adherence in women with persistent delusional symptoms who are treated with antipsychotics. Personality features, intensity of delusion, perception of adverse effects, and cognitive impairment are patient factors. Clinical time spent with the patient, clarity of communication, and regular drug monitoring are responsibilities of the health provider. Factors that neither patient nor clinician can control are the social determinants of health, such as poverty, easy access to healthcare, and cultural variables.
CONCLUSION
There has been little investigation of factors that influence adherence in the target population, e.g., women with DD. Preliminary results of this literature search indicate that solutions from outside the field of DD may apply to this population. Overall, a solid therapeutic alliance appears to be the best hedge against nonadherence.
Topics: Antipsychotic Agents; Female; Humans; Medication Adherence; Schizophrenia, Paranoid
PubMed: 35272589
DOI: 10.2174/1381612828666220310151625 -
Psychiatry Research Apr 2022Patients with delusional disorder (DD) are at an increased risk for the development of depressive symptoms. We aimed to examine the literature dealing with assessment... (Review)
Review
Patients with delusional disorder (DD) are at an increased risk for the development of depressive symptoms. We aimed to examine the literature dealing with assessment tools to assess depressive symptoms in DD. A systematic review was performed by searching PubMed, Scopus and clinicaltrials.gov databases from inception until June 2021 (PRISMA guidelines). From 1863 initial retrieved records, 11 studies were included (N = 715 DD patients). Depressive comorbidity ranged from 20.9% to 53.5%. Seven studies used semistructured/structured interviews: OPCRIT 4.0 (n = 1), Manual for Assessment and Documentation of Psychopathology in Psychiatry (AMDP System) (n = 2), the MINI interview (n = 1), DSM-IV (n = 1), ICD-10 (n = 1); and the Diagnostic Interview Schedule (DIS-R) (n = 1). Seven studies used at least one observer-rated scale: Positive and Negative Syndrome Scale (PANSS)-depressive component (n = 2), Hamilton Rating Scale for Depression (HRSD, n = 3), Montgomery-Asberg Depression Rating Scale (MADRS, n = 1), Clinical Global Impression Scale (CGI, n = 1) and the Bipolar Affective Disorder Dimension Scale (BADDS, n = 1). Assessment scales administered in depressive disorders and schizophrenia are applied to DD. This is the first systematic review exploring the use of assessment tools for depressive symptoms in DD. The use of the MADRS to assess depressive symptoms can be recommended in combination with other clinical scales, for instance, the CGI.
Topics: Bipolar Disorder; Depression; Diagnostic and Statistical Manual of Mental Disorders; Humans; Psychiatric Status Rating Scales; Psychometrics; Schizophrenia, Paranoid
PubMed: 35150968
DOI: 10.1016/j.psychres.2022.114435 -
Ryoikibetsu Shokogun Shirizu 2003
Review
Topics: Ambulatory Care; Anti-Anxiety Agents; Antipsychotic Agents; Diagnostic and Statistical Manual of Mental Disorders; Drug Therapy, Combination; Hospitalization; Humans; Psychotherapy; Reference Standards; Schizophrenia, Paranoid; Social Environment
PubMed: 12876941
DOI: No ID Found -
Clinical Microbiology Reviews Oct 2009This papers aims at familiarizing psychiatric and nonpsychiatric readers with delusional infestation (DI), also known as delusional parasitosis. It is characterized by... (Review)
Review
This papers aims at familiarizing psychiatric and nonpsychiatric readers with delusional infestation (DI), also known as delusional parasitosis. It is characterized by the fixed belief of being infested with pathogens against all medical evidence. DI is no single disorder but can occur as a delusional disorder of the somatic type (primary DI) or secondary to numerous other conditions. A set of minimal diagnostic criteria and a classification are provided. Patients with DI pose a truly interdisciplinary problem to the medical system. They avoid psychiatrists and consult dermatologists, microbiologists, or general practitioners but often lose faith in professional medicine. Epidemiology and history suggest that the imaginary pathogens change constantly, while the delusional theme "infestation" is stable and ubiquitous. Patients with self-diagnosed "Morgellons disease" can be seen as a variation of this delusional theme. For clinicians, clinical pathways for efficient diagnostics and etiology-specific treatment are provided. Specialized outpatient clinics in dermatology with a liaison psychiatrist are theoretically best placed to provide care. The most intricate problem is to engage patients in psychiatric therapy. In primary DI, antipsychotics are the treatment of choice, according to limited but sufficient evidence. Pimozide is no longer the treatment of choice for reasons of drug safety. Future research should focus on pathophysiology and the neural basis of DI, as well as on conclusive clinical trials, which are widely lacking. Innovative approaches will be needed, since otherwise patients are unlikely to adhere to any study protocol.
Topics: Ectoparasitic Infestations; Humans; Schizophrenia, Paranoid
PubMed: 19822895
DOI: 10.1128/CMR.00018-09 -
International Journal of Environmental... Jun 2020Delusional disorders (DD) are difficult conditions for health professionals to treat successfully. They are also difficult for family members to bear. The aim of this... (Review)
Review
Delusional disorders (DD) are difficult conditions for health professionals to treat successfully. They are also difficult for family members to bear. The aim of this narrative review is to select from the clinical literature the psychosocial interventions that appear to work best for these conditions and to see whether similar strategies can be modeled or taught to family members so that tensions at home are reduced. Because the content of men's and women's delusions sometimes differ, it has been suggested that optimal interventions for the two sexes may also differ. This review explores three areas: (a) specific treatments for men and women; (b) recommended psychological approaches by health professionals, especially in early encounters with patients with DD; and (c) recommended psychoeducation for families. Findings are that there is no evidence for differentiated psychosocial treatment for men and women with delusional disorder. What is recommended in the literature is to empathically elicit the details of the content of delusions, to address the accompanying emotions rather than the logic of the presented argument, to teach self-soothing techniques, and to monitor behavior with respect to its safety. These recommendations have only been validated in individual patients and families. More rigorous clinical trials need to be conducted.
Topics: Delusions; Emotions; Family; Female; Humans; Male; Schizophrenia, Paranoid
PubMed: 32630566
DOI: 10.3390/ijerph17124583 -
International Journal of Psychiatry in... 2013Delusional disorder is an infrequent diagnosis in outpatient clinical practice. While delusional thought processes are a fairly common part of symptom clusters in... (Review)
Review
OBJECTIVE
Delusional disorder is an infrequent diagnosis in outpatient clinical practice. While delusional thought processes are a fairly common part of symptom clusters in chronic psychiatric disorders such as schizophrenia and bipolar disorders, true delusional disorders are believed to be fairly rare.
METHOD
In this article, we review scientific data on incidence, diagnosis, and treatment of delusional disorders. This was done by PubMed search utilizing the search terms "delusional disorder," "oncology," "diagnosis," and "treatment." Relevant articles were excluded if they dealt predominantly with schizophrenia instead of primary delusional disorder.
RESULTS
We present a case of a patient diagnosed with follicular lymphoma and an apparent longstanding history of persecutory delusions. The patient's symptoms eventually led to intervention in the oncology practice involving the medical center faculty and staff, as well as local police and the court system.
CONCLUSIONS
Delusional disorder is an under-researched condition, and limited information is known regarding the treatment of this condition when it impacts upon medical care. Future research directions are proposed.
Topics: Comorbidity; Criminals; Humans; Lymphoma, Follicular; Male; Middle Aged; Schizophrenia, Paranoid
PubMed: 24066407
DOI: 10.2190/PM.45.3.c -
Psychopathology 2012In recent decades, there has been a growing interest in the field of delusions, and different aspects of delusional disorder (DD) have been investigated. However, DD is... (Review)
Review
In recent decades, there has been a growing interest in the field of delusions, and different aspects of delusional disorder (DD) have been investigated. However, DD is still one of the most underresearched psychiatric disorders. In this paper, we review the literature on DD and most of the theoretical approaches proposed to explain the development and maintenance of delusions. DD research is infrequent, and delusions in this disorder have been scarcely investigated. We aim to establish the state of the art of delusions research to date and point to the shortage of neuropsychological studies in patients with DD. We also justify the need for future research into the neuropsychological correlates of DD as measured in patients with this disorder given that most previous research has mainly focused on other psychotic conditions.
Topics: Affect; Attention; Delusions; Humans; Psychological Theory; Schizophrenia, Paranoid
PubMed: 22269940
DOI: 10.1159/000327899 -
European Psychiatry : the Journal of... Jan 2019Even if neurocognition is known to affect functional outcomes in schizophrenia, no previous study has explored the impact of cognition on functionality in delusional...
BACKGROUND
Even if neurocognition is known to affect functional outcomes in schizophrenia, no previous study has explored the impact of cognition on functionality in delusional disorder (DD). We aimed to assess the effect of clinical characteristics, symptom dimensions and neuropsychological performance on psychosocial functioning and self-perceived functional impairment in DD.
METHODS
Seventy-five patients with a SCID-I confirmed diagnosis of DD underwent neurocognitive testing using a neuropsychological battery examining verbal memory, attention, working memory and executive functions. We assessed psychotic symptoms with the Positive and Negative Syndrome Scale, and calculated factor scores for four clinical dimensions: Paranoid, Cognitive, Affective and Schizoid. We conducted hierarchical linear regression models to identify predictors of psychosocial functioning, as measured with the Global Assessment of Functioning scale, and self-perceived functional impairment, as measured with the Sheehan's Disability Inventory.
RESULTS
In the final linear regression models, higher scores in the Paranoid (β= 0.471, p < .001, r = 0.273) and Cognitive (β = 0.325, p < .001, r = 0.180) symptomatic dimensions and lower scores in verbal memory (β = -0.273, p < .05, r = 0.075) were significantly associated with poorer psychosocial functioning in patients with DD. Lower scores in verbal memory (β= -0.337, p < .01, r = 0.158) and executive functions (β= -0.323, p < .01, r = 0.094) were significantly associated with higher self-perceived disability.
CONCLUSIONS
Impaired verbal memory and cognitive symptoms seem to affect functionality in DD, above and beyond the severity of the paranoid idea. This suggests a potential role for cognitive interventions in the management of DD.
Topics: Adult; Attention; Cognition; Cognitive Behavioral Therapy; Disability Evaluation; Executive Function; Female; Humans; Male; Memory; Middle Aged; Neuropsychological Tests; Paranoid Disorders; Psychotic Disorders; Schizophrenia, Paranoid; Self-Assessment; Social Skills
PubMed: 30388425
DOI: 10.1016/j.eurpsy.2018.09.010 -
Ryoikibetsu Shokogun Shirizu 2003
Review
Topics: Diagnosis, Differential; Diagnostic and Statistical Manual of Mental Disorders; Humans; Schizophrenia, Paranoid
PubMed: 12876937
DOI: No ID Found